Severe gout: Strategies and innovations for effective management - 10/09/17

Doi : 10.1016/j.jbspin.2016.10.004

Eliseo Pascual ^a,^b,^⁎ , Mariano Andrés ^a,^b, Janitzia Vázquez-Mellado ^c, Nicola Dalbeth ^d
^a Sección de Reumatología, Hospital General Universitario de Alicante, Av. Pintor Baeza 12, 03010 Alicante, Spain
^b Departamento de Medicina Clínica (Reumatología), Universidad Miguel Hernández, Carretera Nacional 332 S/N, 03550, San Juan de Alicante, 03010 Alicante, Spain
^c Servicio de Reumatología, Hospital General de México, Dr. Balmis 148, Cuauhtémoc, Doctores, 06726 Ciudad de México, D.F., Mexico
^d Department of Rheumatology, Auckland District Health Board and Department of Medicine, University of Auckland, Auckland 1010, New Zealand

^⁎Corresponding author at: Sección de Reumatología, Hospital General Universitario de Alicante, Pintor Baeza 12, 03010 Alicante, Spain.Sección de Reumatología, Hospital General Universitario de AlicantePintor Baeza 12Alicante03010Spain

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Abstract

Severe gout is characterised by frequent polyarticular flares, numerous tophi, joint damage, and musculoskeletal disability. This is a preventable condition and in many cases, represents a disease that has been insufficiently managed for years. Standard management recommendations may be insufficient for patients with severe gout; these patients frequently require intensive individualised pharmacological management with combinations of urate-lowering therapy and anti-inflammatory agents. In this article, we aim to integrate recent therapeutic advances to provide a practical framework for optimal management of severe gout.

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Keywords : Severe gout, Refractory, Management, Colchicine, Allopurinol, Febuxostat, Tophus